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Short Environmental Assessment Form Part 1 - Project Information Instructions for Completing Part 1 – Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part 1 – Project and Sponsor Information Name of Action or Project: Town of Hamburg Ambulance District Formation Project Location (describe, and attach a location map): Town of Hamburg, NY Brief Description of Proposed Action: The Town of Hamburg is considering petitioning for the formation of a Town of Hamburg Ambulance District to provide prehospital emergency medical services and including general ambulance services to transport sick or injured persons within the boundaries of the District to a hospital or other place for treatment. The District could include: (i) all properties within the boundaries of the Town, but excluding properties located within the Villages of Blasdell and Hamburg (the “Villages”); (ii) all properties within the boundaries of the Town, including properties located within the Villages; or (iii) all properties within the boundaries of the Town, but excluding properties located one of the Villages. (See attached Map, Plan, and Report). Name of Applicant or Sponsor: Telephone: 716-649-6111 Town of Hamburg E-Mail: Address: 6100 South Park Avenue City/PO: State: Zip Code: Hamburg NY 14075 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, NO YES administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If No, continue to question 2. ✔ 2. Does the proposed action require a permit, approval or funding from any other government Agency? NO YES If Yes, list agency(s) name and permit or approval: ✔ 3. a. Total acreage of the site of the proposed action? N/A acres b. Total acreage to be physically disturbed? N/A acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? N/A acres 4. Check all land uses that occur on, are adjoining or near the proposed action: □ Urban Rural (non-agriculture) Industrial Commercial Residential (suburban) □ Forest Agriculture Aquatic ■ Other(Specify): Action involves the formation of ambulance district in the Town, the boundaries of which could Parkland include the Villages of Hamburg and/or Blasdell. Page 1 of 3 SEAF 2026 103